Perinatal substance use remains a substantial health concern across the United States, but also locally within the state of Wisconsin. A 2020 national study found that 10% of pregnant persons report current alcohol use, with 40% of those individuals also reporting concurrent use of at least one other substance (England et al., 2020). However, substance use is often under-reported and varies by substance used, even among those who are self-reported substance users in a primary care setting (Bone et al., 2016). The prevalence rate of substance use disorder among pregnant persons in WI is 16.6% (WI Department of Health Services, 2020), yet it is likely that this number is also inaccurate. Any substance use, including perinatal substance use, carries the risk of overdose. Thus, accurately and comprehensively understanding perinatal substance use is critically important to preventing morbidity and mortality.